| NPI | 1720176860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 6485LICSW) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MN 6485LICSW) |
| 1041C0700X Social Worker, Clinical (Licence: MN 6485LICSW) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2025-09-11 |