| NPI | 1699971440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA PT22264) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2025-08-20 |