NPI | 1578517173 |
---|---|
Former Name | SUSAN D FLEMMING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MN 4656) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN LMFT1043) |
Enumeration Date | 2006-05-19 |
Last Update Date | 2020-07-02 |