| NPI | 1861908261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MN 01953) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 11391) |
| 101YM0800X Counselor, Mental Health (Licence: NY 012680) | |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2026-03-20 |