Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | LCS23841 | CA |
N | 1041C0700X | Clinical Social Worker | LCSW23841 | CA |
NPI | 1003142340 |
---|---|
Provider Name | Mrs. Erin O. Liiv |
First Address | Bodega, CA 94922-0049 |
Second Address | Santa Rosa, CA 95401-7112 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2009 |
Last Update Date | 23/08/2021 |