| NPI | 1972678191 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 2122) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 167) |
| 1041C0700X Social Worker, Clinical (Licence: MN 581) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2018-11-14 |