| NPI | 1629508882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1082019-1-CDT) |
| Additional Taxonomies | 175T00000X Peer Specialist (Licence: MN 1082019-1-CDT) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |