| NPI | 1790204394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA LPT40582) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA 40582) |
| Enumeration Date | 2017-09-14 |
| Last Update Date | 2020-09-25 |