| NPI | 1134550502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6293) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: VA 0810004913) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2023-12-21 |