| NPI | 1366629081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN 00260) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MN LPCC 260) |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2018-03-01 |