| NPI | 1639897424 |
|---|---|
| Former Name | ELIZABETH BONIFACIC BEAMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305421) |
| Enumeration Date | 2022-08-17 |
| Last Update Date | 2022-08-17 |