| NPI | 1154649358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 31787) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 307197) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2025-09-16 |