| NPI | 1972622694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN 27820) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MN 27820) |
| 1041C0700X Social Worker Clinical (Licence: WI 8126-123) | |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2024-10-15 |