| NPI | 1700284452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc01429) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MN 01687) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2017-06-21 |