| NPI | 1619100138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP3383) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP3383) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP3383) | |
| Enumeration Date | 2009-08-31 |
| Last Update Date | 2010-02-20 |