| NPI | 1992244552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 167G00000X Licensed Psychiatric Technician |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 167G00000X Licensed Psychiatric Technician (Licence: CA 41444) | |
| Enumeration Date | 2017-02-15 |
| Last Update Date | 2025-08-14 |