NPI | 1528536760 |
---|---|
Former Name | DIANDRA ELISE CARSTENSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW101217) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW78774) |
Enumeration Date | 2018-11-06 |
Last Update Date | 2021-05-03 |