| NPI | 1164617015 |
|---|---|
| Former Name | KIMBERLY RUTH IVES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW62673) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CA 62637) |
| 104100000X Social Worker | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2022-04-04 |