| NPI | 1770916322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2693) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MN 1-15-20652) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2017-03-06 |