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) |
101YP2500X Counselor, Professional (Licence: MN 3470) | |
Enumeration Date | 2017-09-28 |
Last Update Date | 2023-12-09 |