| NPI | 1912342130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 113807) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA PT35706) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2025-03-28 |