| NPI | 1467677690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 27075) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: ND 98-7-1-91-17) |
| 101Y00000X Counselor (Licence: MN 00096) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1350) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 300752) | |
| 101YM0800X Counselor, Mental Health (Licence: ND 98-7-1-91-17) | |
| Enumeration Date | 2007-04-14 |
| Last Update Date | 2025-09-11 |