| NPI | 1982077541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 27157) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MN 303368) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 1051960) | |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2024-10-16 |