| NPI | 1154305126 |
|---|---|
| Former Name | LISA R CLEMENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP3904) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN 3904) |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2020-09-18 |