| NPI | 1508207044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc00963) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303570) |
| 101YP2500X Counselor, Professional (Licence: MN 01317) | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2021-11-04 |