| NPI | 1609955624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 00206) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ND 455-121-1-00-140) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |