| NPI | 1023432747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc01264) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303799) |
| 101YP2500X Counselor, Professional (Licence: MN 1264) | |
| Enumeration Date | 2014-02-17 |
| Last Update Date | 2024-06-17 |