| NPI | 1164910030 |
|---|---|
| Former Name | SAMANTHA CRISMOND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 94378) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 66619) |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2022-01-18 |