NPI | 1497356885 |
---|---|
Former Name | NA NA NA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 129419) |
Additional Taxonomies | 101Y00000X Counselor (Licence: 62730) |
101YM0800X Counselor, Mental Health (Licence: 62730) | |
Enumeration Date | 2020-11-03 |
Last Update Date | 2025-05-19 |