| NPI | 1790063311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 90870) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: CA 68014) | |
| 104100000X Social Worker (Licence: CA 68014) | |
| Enumeration Date | 2011-07-31 |
| Last Update Date | 2023-07-12 |