| NPI | 1497079743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302806) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 20022) |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2010-03-16 |