| NPI | 1154750164 |
|---|---|
| Former Name | KIMBERLY CARL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 76821) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker (Licence: CA 61501) | |
| 1041C0700X Social Worker, Clinical (Licence: CA 61501) | |
| Enumeration Date | 2013-11-11 |
| Last Update Date | 2022-07-21 |