| NPI | 1457432080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301640) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: MN 404249) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-06-03 |