NPI | 1821242744 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA 34123) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA PT 34123) |
Enumeration Date | 2008-11-05 |
Last Update Date | 2021-01-11 |