| NPI | 1649623919 |
|---|---|
| Former Name | RAVEN GARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA ACSW72356) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 72356) |
| 104100000X Social Worker (Licence: CA ACSW72356) | |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2022-02-16 |