| NPI | 1184054280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN LP3392) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP3392) |
| 103TC1900X Psychologist, Counseling (Licence: MN LP3392) | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2023-12-12 |