| NPI | 1972989606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 97597) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CA 77134) |
| 101YM0800X Counselor, Mental Health (Licence: CA 77134) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2020-10-19 |