| NPI | 1205186608 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW98143)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW63521)  | 
| Enumeration Date | 2012-09-12 | 
| Last Update Date | 2020-12-04 |