| NPI | 1659432912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 8677) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 00452) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2011-11-30 |