| NPI | 1306516091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 111755) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 111755) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2023-06-14 |