| NPI | 1689383861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 127072-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 05050) |
| 101Y00000X Counselor | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306607) | |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2026-06-26 |