| NPI | 1760709943 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW82225) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2024-07-10 |