| NPI | 1124451836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 93994) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA ASW67892) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2022-07-21 |