| NPI | 1801234653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA 288135) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 288135) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CA 288135) | |
| Enumeration Date | 2013-06-13 |
| Last Update Date | 2020-10-28 |