| NPI | 1952473134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP0063) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 00634) |
| 1041C0700X Social Worker, Clinical (Licence: IA 00313) | |
| 106H00000X Marriage & Family Therapist (Licence: MN 200) | |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2007-07-08 |