| NPI | 1578956702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 19836) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 19836) |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2024-01-02 |