| NPI | 1164912119 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN CC03511) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MN 1-14-16436) |
| Enumeration Date | 2018-05-15 |
| Last Update Date | 2022-10-18 |