| NPI | 1992050884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician (Licence: 36580) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA PT36580) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2022-09-01 |