| NPI | 1801989157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN 2628) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 0244) |
| Enumeration Date | 2006-10-01 |
| Last Update Date | 2007-07-08 |