| NPI | 1790984227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP 5311) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: AZ 3252) |
| 103TF0000X Psychologist, Family (Licence: AZ 3252) | |
| 103TF0000X Psychologist, Family (Licence: MN LP 5311) | |
| Enumeration Date | 2007-07-14 |
| Last Update Date | 2012-03-19 |