| NPI | 1265259113 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NM SWB-2022-0714) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CA LCSW29617) |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-10-01 |