| NPI | 1295934503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc01094) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA imf 53265) |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2019-10-29 |