| NPI | 1992263784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: 2424) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 2259) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304934) | |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2020-05-13 |