| NPI | 1811222128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW64235) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 28478) |
| 101YM0800X Counselor, Mental Health (Licence: CA ASW 28478) | |
| 104100000X Social Worker | |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2019-10-18 |