| NPI | 1649940420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 4302) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 15221) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305504) | |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2025-01-06 |