| NPI | 1376855163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA 38346) |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2022-07-14 |