NPI | 1760079396 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6790) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN cc00630) |
Enumeration Date | 2020-12-29 |
Last Update Date | 2022-12-27 |