| NPI | 1104880327 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4256) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO 2032) |
| 103T00000X Psychologist (Licence: IL 071-004153) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2021-03-11 |