| NPI | 1689240442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MN 3549) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305812) |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2024-02-27 |