| NPI | 1609450428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 11704) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 301020) |
| 1041C0700X Social Worker Clinical (Licence: HI LCSW-3911) | |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2023-02-23 |