| NPI | 1972801090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2198) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302970) |
| 101YM0800X Counselor, Mental Health (Licence: MN 2198) | |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2018-10-29 |