| NPI | 1437548088 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA LCSW127917) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW98995) |
| 104100000X Social Worker (Licence: CA ASW98995) | |
| 1041C0700X Social Worker, Clinical (Licence: CA ASW98995) | |
| Enumeration Date | 2015-01-21 |
| Last Update Date | 2025-01-16 |