| NPI | 1104054329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5121) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MN LBA0113) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2025-07-09 |