| NPI | 1750700027 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 6587) |
| Additional Taxonomies | 103T00000X Psychologist |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301529) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2023-04-13 |