| NPI | 1275972499 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 72238)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 72238)  | 
| Enumeration Date | 2013-06-20 | 
| Last Update Date | 2016-07-21 |