| NPI | 1750989174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305623) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1920) |
| 101YM0800X Counselor, Mental Health (Licence: MN 2367) | |
| 101YM0800X Counselor, Mental Health (Licence: MN cc03452) | |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2022-12-16 |