| NPI | 1902116544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 70793) |
| Additional Taxonomies | 101Y00000X Counselor |
| 104100000X Social Worker (Licence: CA 30762) | |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2020-11-27 |