| NPI | 1639064223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: MN 404973) |
| Enumeration Date | 2025-06-12 |
| Last Update Date | 2025-06-12 |