| NPI | 1215618632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MN 09876) |
| 101Y00000X Counselor | |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2023-07-27 |