| NPI | 1457541286 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 1376)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302200)  | 
| Enumeration Date | 2007-07-27 | 
| Last Update Date | 2016-12-07 |