| NPI | 1386267110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 03725) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305785) |
| 101YP2500X Counselor, Professional (Licence: MN 2521) | |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2023-03-14 |