| NPI | 1053399972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 3025) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN 3025) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN 3025) | |
| 103TF0000X Psychologist, Family (Licence: MN 3025) | |
| 103T00000X Psychologist (Licence: MN 3025) | |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2007-07-08 |