| NPI | 1134766470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 1869) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303967) |
| 101YM0800X Counselor, Mental Health (Licence: MN 1869) | |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2024-06-07 |