| NPI | 1972012391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN 3470) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 305599) |
| 101YM0800X Counselor Mental Health (Licence: IA 127583) | |
| 101YM0800X Counselor Mental Health (Licence: WI 11190-125) | |
| 101YP2500X Counselor Professional (Licence: MN 3470) | |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2025-03-17 |