| NPI | 1922479310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 4702) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 1034-124) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2025-07-11 |