| NPI | 1619159563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR 7857) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: CA LCSW 71967) | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2021-05-19 |