| NPI | 1154774230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 125028) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 125028) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2024-08-12 |