| NPI | 1104985175 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 5135) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 1041C0700X Social Worker, Clinical (Licence: MN 1248) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2011-03-23 |