| NPI | 1982886503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301542) |
| 1041C0700X Social Worker, Clinical (Licence: MN 15251) | |
| Enumeration Date | 2007-12-05 |
| Last Update Date | 2016-04-20 |