| NPI | 1629032420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 286) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MN 7347) |
| 106H00000X Marriage & Family Therapist (Licence: MN 165) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2008-05-30 |