| NPI | 1619627551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN Cc04077) |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2025-08-06 |