| NPI | 1750887600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 24283) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 20161) |
| 1041C0700X Social Worker, Clinical (Licence: MN 24283) | |
| Enumeration Date | 2018-03-31 |
| Last Update Date | 2023-03-13 |