| NPI | 1205582988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP3737) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: 41803) |
| 163W00000X Registered Nurse (Licence: MN 831570) | |
| Enumeration Date | 2022-02-22 |
| Last Update Date | 2022-02-22 |