| NPI | 1992397368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 4633) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2025-06-10 |