| NPI | 1952473134 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 200)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP0063)  | 
| 1041C0700X Social Worker, Clinical (Licence: MN 00634)  | |
| 1041C0700X Social Worker, Clinical (Licence: IA 00313)  | |
| Enumeration Date | 2006-11-14 | 
| Last Update Date | 2025-09-11 |