NPI | 1902409493 |
---|---|
Former Name | CRYSTAL DIANNA HURTADO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW118803) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 98041) |
104100000X Social Worker (Licence: CA 98041) | |
Enumeration Date | 2020-11-18 |
Last Update Date | 2025-01-15 |