| NPI | 1609041243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3506) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 835) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |