NPI | 1972023802 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 98615) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 83988) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-06-21 |
Last Update Date | 2022-07-21 |