| NPI | 1730726910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 105334) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 1041C0700X Social Worker, Clinical (Licence: CA 105334) | |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2022-12-07 |