| NPI | 1588094809 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc01365)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303444)  | 
| 101YP2500X Counselor, Professional (Licence: MN 1365)  | |
| Enumeration Date | 2013-11-22 | 
| Last Update Date | 2023-06-10 |