| NPI | 1801372867 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 124561) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA 124561) |
| 101YM0800X Counselor, Mental Health (Licence: CA 124561) | |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2026-04-02 |