| NPI | 1639650310 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 128201) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: CA 89609) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2025-01-29 |