| NPI | 1720685019 |
|---|---|
| Former Name | MADELINE GANDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 26891) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304991) |
| 101YM0800X Counselor, Mental Health (Licence: MN 26891) | |
| Enumeration Date | 2020-10-08 |
| Last Update Date | 2024-07-30 |