| NPI | 1063949113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN 1913) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 7268-125) |
| Enumeration Date | 2017-05-19 |
| Last Update Date | 2024-12-30 |