| NPI | 1750622080 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 3682)  | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 1037-124)  | 
| Enumeration Date | 2013-03-12 | 
| Last Update Date | 2018-06-19 |