| NPI | 1073006524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 6660) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MN 1-05-2231) |
| Enumeration Date | 2018-06-10 |
| Last Update Date | 2022-10-26 |