| NPI | 1013666288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305301) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MN 02387) |
| Enumeration Date | 2022-03-23 |
| Last Update Date | 2022-03-23 |