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 |