| NPI | 1003915935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN CC00027) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MN LPC 103) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2024-03-12 |