| NPI | 1881097228 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 4132) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303868) | 
| Enumeration Date | 2014-09-30 | 
| Last Update Date | 2024-07-15 |