| NPI | 1114540143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA 94315) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CA LCSW28777) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2023-10-12 |