| NPI | 1649870593 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 97487) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 97487) |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2023-11-20 |