| NPI | 1124370358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN GL0077) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: DC PSY1000836) |
| 103TC0700X Psychologist, Clinical (Licence: MD 05232) | |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2024-05-06 |