| NPI | 1043415318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: ND 613) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA 94022385) |
| 103TC0700X Psychologist Clinical (Licence: MN LP6706) | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2021-11-17 |