| NPI | 1114100252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6724) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PSY0004280) |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2024-03-19 |