| NPI | 1053541987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6507) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2009026801) |
| Enumeration Date | 2009-07-27 |
| Last Update Date | 2023-09-19 |