NPI | 1821583378 |
---|---|
Former Name | SAMANTHA MENA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW130685) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 100150) |
175T00000X Peer Specialist | |
Enumeration Date | 2018-06-27 |
Last Update Date | 2025-06-25 |