| NPI | 1801047113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5316) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling (Licence: MN LP 5316) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN LP 5316) | |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2018-10-29 |