| NPI | 1235530197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 90801) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 71758) |
| 104100000X Social Worker (Licence: CA 71758) | |
| 1041C0700X Social Worker Clinical (Licence: CA 71758) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2019-12-14 |