| NPI | 1871667568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA LCSW64874) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CO 626) |
| 101YM0800X Counselor Mental Health (Licence: CA 28042) | |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2014-12-18 |