| NPI | 1790238152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc02675) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305743) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0001021) | |
| 101YP2500X Counselor, Professional (Licence: CO 0014953) | |
| 101YP2500X Counselor, Professional (Licence: CO LPP.0001433) | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2022-12-20 |