| NPI | 1558741801 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 67657)  | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YM0800X Counselor, Mental Health (Licence: CA 67657)  | |
| Enumeration Date | 2015-06-02 | 
| Last Update Date | 2015-08-28 |