Individual
CAREY PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ASW
Contact information
Practice address
4641 22ND ST, SACRAMENTO, CA 95822-2018
(916) 212-7086
Mailing address
4641 22ND ST, SACRAMENTO, CA 95822-2018
(916) 212-7086
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
128841
CA
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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