| NPI | 1962554733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: CA PT28878) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: CA PT 28878) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2019-06-14 |