| NPI | 1679619050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP0165) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN LMFT0754) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2013-06-20 |