| NPI | 1639701303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 111323) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1375430120) |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2024-08-12 |