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 |