| NPI | 1265446397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 0290) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 0530) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2025-09-11 |