| NPI | 1407998065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP0723) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 602-124) |
| 101YM0800X Counselor, Mental Health (Licence: MN 362) | |
| 101YM0800X Counselor, Mental Health (Licence: MN 07780) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2025-09-11 |