NPI | 1194976407 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN 5635) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 1701) |
Enumeration Date | 2008-10-06 |
Last Update Date | 2013-08-28 |