NPI | 1124394721 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP5071) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN LP5071) |
Enumeration Date | 2012-03-28 |
Last Update Date | 2023-12-22 |