| NPI | 1861939480 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical (Licence: MN 23466) | |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2023-08-14 |