| NPI | 1063437416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc02114) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ND 1243-9-15-22A) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1530) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2023-12-26 |