| NPI | 1184670275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 3839) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 621-124) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2014-05-02 |