| NPI | 1649928292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN 2376) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 304725) |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2022-03-14 |