| NPI | 1235687245 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 94099) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA ASW64213) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2020-02-18 |