| NPI | 1942583257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN LP5100) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP 5100) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP5100) | |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2023-12-07 |