| NPI | 1982996625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303069) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 1267) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2011-05-13 |