| NPI | 1326003716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP2626) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN MFT0125) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-08 |