NPI | 1417566456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 110333) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA ASW81967) |
101Y00000X Counselor (Licence: CA ASW81967) | |
Enumeration Date | 2020-07-27 |
Last Update Date | 2022-09-13 |