| NPI | 1376984781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6013) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 1931) |
| Enumeration Date | 2013-07-13 |
| Last Update Date | 2022-07-21 |