| NPI | 1407083678 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCS24616) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CA LCS 24616) |
| 101Y00000X Counselor (Licence: CA LPC391) | |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2014-06-04 |