| NPI | 1003619941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 29387) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 29387) |
| Enumeration Date | 2025-03-28 |
| Last Update Date | 2026-01-16 |