| NPI | 1134655913 |
|---|---|
| Former Name | ELIZABETH HALVORSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304404) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2021-11-10 |