| NPI | 1750960068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN 02662) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 304407) |
| Enumeration Date | 2021-04-05 |
| Last Update Date | 2022-06-01 |