| NPI | 1639313539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 19653) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN AP09-524) |
| 101YM0800X Counselor, Mental Health (Licence: ND 4244) | |
| Enumeration Date | 2009-04-23 |
| Last Update Date | 2025-01-09 |