| NPI | 1497616411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc05304) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 12276-125) |
| Enumeration Date | 2025-11-19 |
| Last Update Date | 2026-01-15 |