NPI | 1891046819 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 10162) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 10162) |
103K00000X Behavior Analyst (Licence: MN 10162) | |
Enumeration Date | 2012-10-01 |
Last Update Date | 2012-10-01 |