| NPI | 1023615242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 2527) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304573) |
| Enumeration Date | 2020-10-01 |
| Last Update Date | 2025-03-05 |