| NPI | 1215007281 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW 16669) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health | 
| 171W00000X Contractor (Licence: CA LCSW 16669) | |
| Enumeration Date | 2006-11-08 | 
| Last Update Date | 2019-06-10 |