| NPI | 1235564238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2507) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MN 2507) |
| 101YM0800X Counselor, Mental Health (Licence: MN 2507) | |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2014-04-11 |