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 |