| NPI | 1992463475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN CC4225) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2021-12-02 |
| Last Update Date | 2024-02-07 |