NPI | 1356954150 |
---|---|
Former Name | LISA ANNE GONZALES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 118016) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 96494) |
104100000X Social Worker | |
104100000X Social Worker (Licence: CA 96494) | |
Enumeration Date | 2020-08-31 |
Last Update Date | 2024-04-01 |