| NPI | 1679964175 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW83080)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ACSW67125)  | 
| Enumeration Date | 2015-02-05 | 
| Last Update Date | 2018-08-09 |