| NPI | 1861658643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 08050) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 0241) |
| Enumeration Date | 2008-07-31 |
| Last Update Date | 2008-07-31 |