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Individual
GWENDOLYN LO
Active
Individual
GWENDOLYN LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
ASW 14829
CA
1041C0700X
Clinical Social Worker
Primary
LCSW27906
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AAD3392
—
CA
Enumeration date
10/09/2007
Last updated
07/11/2018
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