| NPI | 1538195862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 4926) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 937) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2008-08-26 |