| NPI | 1255470035 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP0552) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 480) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-07-08 |