| NPI | 1528661519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc03352) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305530) |
| Enumeration Date | 2020-11-20 |
| Last Update Date | 2024-03-26 |