| NPI | 1245955459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 3763) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305668) |
| 101YP2500X Counselor, Professional (Licence: MN 3763) | |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2024-05-24 |