| NPI | 1780164103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303692) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 3658) |
| Enumeration Date | 2018-08-15 |
| Last Update Date | 2018-08-15 |