| NPI | 1073901666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 03124) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1735) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306949) | |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2025-05-22 |