| NPI | 1174916639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 19982) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306135) |
| 1041C0700X Social Worker, Clinical (Licence: WI 8532) | |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2022-08-10 |