| NPI | 1588774871 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 4636)  | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 4636)  | 
| 101YP2500X Counselor, Professional (Licence: MN 4636)  | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: MN 4636)  | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN 4636)  | |
| 103TC0700X Psychologist, Clinical (Licence: MN 4636)  | |
| 103TC1900X Psychologist, Counseling (Licence: MN 4636)  | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN 4636)  | |
| 103TF0000X Psychologist, Family (Licence: MN 4636)  | |
| 103TH0100X Psychologist, Health Service (Licence: MN 4636)  | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MN 4636)  | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN 4636)  | |
| Enumeration Date | 2006-08-30 | 
| Last Update Date | 2025-09-11 |