| NPI | 1124486246 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 3106) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303395) | 
| Enumeration Date | 2016-02-03 | 
| Last Update Date | 2022-07-21 |