| NPI | 1942306964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 00159) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 13033) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2007-07-08 |