| NPI | 1659856821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN CC01944) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN CC01944) |
| Enumeration Date | 2018-10-03 |
| Last Update Date | 2023-02-03 |