| NPI | 1780700039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP3116) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP3116) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN LP3116) | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MN R0803692) | |
| 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: MN R0803692) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2007-07-09 |