| NPI | 1184074940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 22788) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MN 22788) |
| Enumeration Date | 2016-06-13 |
| Last Update Date | 2020-03-25 |