| NPI | 1669815643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 14534) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TP0814X Psychologist, Psychoanalysis | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 103TH0004X Psychologist, Health | |
| 101YM0800X Counselor, Mental Health | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2025-09-09 |