| NPI | 1912375627 |
|---|---|
| Former Name | KAITLYN PATRICIA LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 82954) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 66662) |
| 104100000X Social Worker | |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2022-03-18 |