NPI | 1497888903 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 02179) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 0154) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2010-01-07 |