| NPI | 1083446876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN 11409) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MN 11409) |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MN 11409) | |
| Enumeration Date | 2024-08-19 |
| Last Update Date | 2024-08-19 |