| NPI | 1205338639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCSW113153) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA ACSW106131) |
| 101YM0800X Counselor Mental Health (Licence: CA 69847) | |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2023-02-28 |