| NPI | 1447895065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN CC02005) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: 304433) |
| Enumeration Date | 2019-11-07 |
| Last Update Date | 2019-12-11 |