| NPI | 1700390317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MN 24578) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MN 24578) |
| 1041C0700X Social Worker, Clinical (Licence: MN 24578) | |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2021-08-05 |