| NPI | 1184484214 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN 4047) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MN CC04047) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 303773) | |
| Enumeration Date | 2024-03-19 |
| Last Update Date | 2024-05-30 |