NPI | 1710115860 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6667) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 1394) |
Enumeration Date | 2009-06-28 |
Last Update Date | 2024-10-02 |