| NPI | 1366682387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA 34435) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA PT34435) |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2024-01-08 |