| NPI | 1700042801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6596) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN cc00350) |
| 106H00000X Marriage & Family Therapist (Licence: MN 2550) | |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2020-10-02 |