| NPI | 1194600239 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YS0200X Counselor, School |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical (Licence: CA 129645) | |
| 1041S0200X Social Worker, School | |
| Enumeration Date | 2025-08-07 |
| Last Update Date | 2025-08-07 |