| NPI | 1275959579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA PT37178) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2014-03-11 |
| Last Update Date | 2024-03-19 |