| NPI | 1982908505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CA 64414) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 27925) |
| 101YM0800X Counselor Mental Health (Licence: CA 64414) | |
| Enumeration Date | 2010-12-23 |
| Last Update Date | 2021-03-12 |