| NPI | 1912967829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP2873) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 8526) |
| 106H00000X Marriage & Family Therapist (Licence: MN 64) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2021-02-02 |