| NPI | 1255560447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 24779) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 24779) |
| 101YM0800X Counselor, Mental Health (Licence: CA 24779) | |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2011-04-21 |