| NPI | 1124981667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 5330) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MN L763651) |
| Enumeration Date | 2025-12-03 |
| Last Update Date | 2025-12-03 |