| NPI | 1740943604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 128509) |
| Additional Taxonomies | 104100000X Social Worker (Licence: Intern) |
| 106S00000X Behavior Technician | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2025-03-31 |