| NPI | 1962712638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 00969) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN LPC00969) |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2011-08-25 |