| NPI | 1205499456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA PT38153) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2020-04-13 |