| NPI | 1205200854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164X00000X Licensed Vocational Nurse (Licence: CA LVN280796) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA LVN280796) |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2020-12-15 |