| 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 |