| NPI | 1871242370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306255) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: MN 30060) |
| Enumeration Date | 2022-03-22 |
| Last Update Date | 2022-04-12 |