| NPI | 1053740464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2692) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 2268-124) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2025-09-19 |