| NPI | 1689383861 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 5050) | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306607) | |
| Enumeration Date | 2022-11-16 | 
| Last Update Date | 2025-07-09 |