| NPI | 1124646815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA PT42019) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2023-12-12 |