| NPI | 1942306964 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 13033) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 00159) | 
| Enumeration Date | 2006-09-16 | 
| Last Update Date | 2025-09-11 |