NPI | 1336650407 |
---|---|
Former Name | NATALIA AYELEN PARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 109423) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 81384) |
Enumeration Date | 2017-10-17 |
Last Update Date | 2022-11-03 |