| NPI | 1124180336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP2493) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MN 6907) |
| 163W00000X Registered Nurse (Licence: MN R0836193) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-07-08 |