| NPI | 1053823104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN CC00947) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 22991) |
| Enumeration Date | 2017-10-30 |
| Last Update Date | 2017-10-30 |