| NPI | 1538889589 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc03143) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN 3143) | 
| Enumeration Date | 2022-08-30 | 
| Last Update Date | 2023-12-07 |