| NPI | 1811069743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP 3972) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN LP3972) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2015-10-14 |