| NPI | 1053095638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP6423) |
| Additional Taxonomies | 103TH0004X Psychologist Health |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2023-06-14 |