| NPI | 1265022008 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 4124) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19106130) |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2025-01-09 |