| NPI | 1689664187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc03297) |
| Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: MN 61967) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305602) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2023-06-06 |