NPI | 1154987063 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 300366) |
Additional Taxonomies | 405300000X Prevention Professional (Licence: MN 300366) |
Enumeration Date | 2019-05-15 |
Last Update Date | 2022-03-08 |