| NPI | 1508616962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 18442) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306212) |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2025-03-02 |