| NPI | 1376968263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 18303) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 11524) |
| 167G00000X Licensed Psychiatric Technician (Licence: CA 34932) | |
| 247200000X Technician, Other (Licence: CA 34932) | |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2025-08-22 |