| NPI | 1679743819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 1600) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN LMFT 1600) |
| 164W00000X Licensed Practical Nurse (Licence: MN L045972-9) | |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2024-11-11 |