| NPI | 1740577881 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 89452) | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2011-07-08 | 
| Last Update Date | 2019-07-18 |