| NPI | 1073603163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP4924) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP4924) |
| 106H00000X Marriage & Family Therapist (Licence: MN MN #1351) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-10-24 |