| NPI | 1669759825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MN 302988) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302988) |
| 101YP2500X Counselor, Professional (Licence: MN cc04013) | |
| 101YP2500X Counselor, Professional (Licence: MN 04013) | |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2024-10-15 |