| NPI | 1083740286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP4371) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: CA PSY15185) |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2007-07-08 |