| NPI | 1124608658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 16202) |
| Additional Taxonomies | 1041S0200X Social Worker School (Licence: MN 16202) |
| Enumeration Date | 2021-04-09 |
| Last Update Date | 2021-04-09 |