| NPI | 1639475049 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA 28726) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA PT28726) |
| Enumeration Date | 2011-02-02 |
| Last Update Date | 2024-01-04 |