| NPI | 1720584808 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW110501)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW15237)  | 
| Enumeration Date | 2018-04-05 | 
| Last Update Date | 2022-12-12 |