| NPI | 1811313950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc00656) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303813) |
| 101YP2500X Counselor, Professional (Licence: MN CC00656) | |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2019-10-11 |