| NPI | 1083923239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP6668) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MA 9252) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2023-08-30 |