| NPI | 1679750608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 300170) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R-062487-1) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |