| NPI | 1538738919 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc04367)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306052)  | 
| Enumeration Date | 2021-06-21 | 
| Last Update Date | 2024-04-22 |