| NPI | 1063637627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP4767) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: WI 2626-057) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-07-08 |