| NPI | 1013108075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP1130) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MN 1130) |
| 103TC0700X Psychologist, Clinical (Licence: MN 1130) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2021-12-22 |