| 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 |