| NPI | 1902236078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN LP3239) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MN LP3239) |
| 103TC0700X Psychologist Clinical (Licence: MN LP3239) | |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2023-12-07 |