| NPI | 1093735045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4836) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 33052) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-05-05 |