| NPI | 1902120074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 1916) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R91359-5) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-06-20 |