| NPI | 1124555743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 88419) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 65975) |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2019-05-01 |