| NPI | 1962189563 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 104100000X Social Worker (Licence: MN 30317)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 30317)  | 
| 101Y00000X Counselor (Licence: MN 30317)  | |
| Enumeration Date | 2023-07-05 | 
| Last Update Date | 2024-06-20 |