| NPI | 1811704141 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc02429) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304701) |
| 101YP2500X Counselor, Professional (Licence: WI 10795-125) | |
| Enumeration Date | 2024-12-11 |
| Last Update Date | 2024-12-11 |