| NPI | 1467990622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301700) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 13727) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-02-08 |