| NPI | 1063912863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 02099) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 02099) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2023-11-26 |