| NPI | 1164963062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MN cc1424) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN cc1424) |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2025-10-22 |