| NPI | 1861836140 |
|---|---|
| Former Name | TINA M LIVINGSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 01241) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN 01241) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2021-11-05 |