| NPI | 1619413382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 2737) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 3404) |
| 101YM0800X Counselor, Mental Health (Licence: MN 02330) | |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2021-02-02 |