| NPI | 1235763780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 115730) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 101YM0800X Counselor, Mental Health (Licence: CA 115730) | |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2026-01-29 |