NPI | 1124206818 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 4875) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MN 4875) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN 4875) | |
103TF0000X Psychologist, Family (Licence: MN 4875) | |
Enumeration Date | 2008-02-05 |
Last Update Date | 2008-02-05 |