| NPI | 1326094962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MN LP0483) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN #386) |
| 103TC0700X Psychologist Clinical (Licence: MN LP0483) | |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2013-05-06 |