| NPI | 1609657162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN CC04281) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 305861) |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2023-10-11 |
| Last Update Date | 2024-04-17 |