| NPI | 1952787491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 303167) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MN 1438) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2015-08-06 |