| NPI | 1174719280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP3024) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM LPCC0112771) |
| 101YM0800X Counselor, Mental Health (Licence: NY 009443) | |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2020-01-05 |