| NPI | 1003297813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 24594) |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2022-03-08 |