| NPI | 1568892644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN CC00672) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MN CC00672) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2024-01-25 |