| NPI | 1699021923 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MN 1145) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MN 1145) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2021-02-20 |