NPI | 1104343144 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW92080) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW73527) |
Enumeration Date | 2017-08-29 |
Last Update Date | 2019-10-04 |