| NPI | 1003061235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2218) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X Community/Behavioral Health (Licence: MN 2218) | |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2022-07-21 |