| NPI | 1306309992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 25623) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN LICSW) |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2020-01-13 |