| NPI | 1558667659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 76113) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 007292) |
| 101YM0800X Counselor, Mental Health (Licence: CA 30472) | |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2021-08-02 |