| NPI | 1659413599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP 5014) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN LMFT 1867) |
| 106H00000X Marriage & Family Therapist (Licence: MN LMFT1867) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2022-04-28 |