NPI | 1104662691 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP7069) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MN LP7069) |
Enumeration Date | 2024-07-03 |
Last Update Date | 2024-09-05 |