| NPI | 1578084455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 101295) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: 82874) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-07-21 |