NPI | 1518588136 |
---|---|
Former Name | MARISSA L ORTIZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 111925) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA 89504) |
101YM0800X Counselor, Mental Health (Licence: CA 89504) | |
Enumeration Date | 2020-05-05 |
Last Update Date | 2025-09-21 |