| NPI | 1508325234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 92354) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA ASW76850) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-10-21 |