| NPI | 1649603994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW93350) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW67468) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2019-12-31 |