| NPI | 1831533819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 6252) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional (Licence: MN 6252) | |
| 103TC0700X Psychologist Clinical (Licence: MN 6252) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2021-03-11 |