| NPI | 1285171108 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 1197) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303614) |
| 101YP2500X Counselor, Professional (Licence: MN 1197) | |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2018-03-17 |