| NPI | 1942867783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 2637) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 02219) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304822) | |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2023-04-04 |