| NPI | 1104371905 |
|---|---|
| Former Name | MAYRA VALENCIA CAMPOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCSW96461) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA LCSW96461) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2021-12-17 |