| NPI | 1558495416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA PT 26589) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA PT 26589) |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-08 |