| NPI | 1629450770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 73614) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA ASW67482) |
| 101YM0800X Counselor, Mental Health (Licence: CT 9056) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2018-02-04 |