| NPI | 1033264734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 5767) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 4060) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2014-09-30 |