| NPI | 1861971566 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc01902) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304844) |
| 221700000X Art Therapist (Licence: MN 16-379) | |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |