| NPI | 1649437419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 15482) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 171400000X | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2022-07-15 |