| NPI | 1710256961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 93822) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 69332) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2020-01-22 |