| NPI | 1831646587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN CC01906) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000605) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303827) | |
| 101YM0800X Counselor, Mental Health (Licence: MN 02041) | |
| 101YM0800X Counselor, Mental Health (Licence: CO LPC.0013098) | |
| 101YP2500X Counselor, Professional (Licence: MN cc01906) | |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2024-02-14 |