| NPI | 1013054642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP1839) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 6878) |
| 106H00000X Marriage & Family Therapist (Licence: MN 497) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-07-09 |