| NPI | 1710003843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN 5308) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 1513) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2012-08-27 |