| NPI | 1528443561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 19078) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 15-08-01) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2021-02-09 |