NPI | 1902395130 |
---|---|
Other Name | JESSICA ANDREA MARCA RENGIFO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW104992) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW76609) |
Enumeration Date | 2018-05-03 |
Last Update Date | 2022-03-09 |