| NPI | 1679883268 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 432)  | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 2091)  | 
| Enumeration Date | 2010-10-15 | 
| Last Update Date | 2022-11-29 |