| NPI | 1396819058 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 28961) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 28961) | 
| Enumeration Date | 2006-11-17 | 
| Last Update Date | 2016-01-04 |