| NPI | 1215016258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MN 1907) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 699) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |