| NPI | 1518181452 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302071) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 13912-132) | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN none assigned) | |
| Enumeration Date | 2007-04-12 | 
| Last Update Date | 2019-11-07 |