NPI | 1770621070 |
---|---|
Former Name | TANYA MARTINEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCS19749) |
Additional Taxonomies | 104100000X Social Worker (Licence: CA LCS19749) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2017-12-01 |