| 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 |