| NPI | 1174204572 |
|---|---|
| Former Name | VANESSA LISETTE BAUTISTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 117915) |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2024-03-09 |