| NPI | 1992876064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP2332) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MN LP2332) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP2332) | |
| 103TF0000X Psychologist, Family (Licence: MN LP2332) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN LP2332) | |
| 106H00000X Marriage & Family Therapist (Licence: MN LP2332) | |
| 101YM0800X Counselor, Mental Health (Licence: MN LP2332) | |
| 103T00000X Psychologist (Licence: MN LP2332) | |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2022-08-01 |