NPI | 1770794828 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP3350) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN LMFT915) |
Enumeration Date | 2007-05-24 |
Last Update Date | 2007-07-08 |