| NPI | 1104987197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCSW28954) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 28954) |
| 1041C0700X Social Worker Clinical (Licence: CA LCS28954) | |
| 251S00000X Community/Behavioral Health (Licence: CA 28954) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2018-01-29 |