| NPI | 1336997063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 4403) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305945) |
| 101YP2500X Counselor, Professional (Licence: MN 4403) | |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2025-07-01 |