NPI | 1548642150 |
---|---|
Former Name | BRENDA PRESTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 87441) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 73782) |
101YM0800X Counselor, Mental Health (Licence: CA ASW73782) | |
Enumeration Date | 2015-06-19 |
Last Update Date | 2024-11-08 |