| NPI | 1285784405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP2578) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN LMFT0280) |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2015-06-30 |