| NPI | 1962968065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305195) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 26713) |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-02-13 |