| NPI | 1609167774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 17355) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 17355) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2011-04-25 |