| NPI | 1164650560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4959) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WY 418) |
| 103TF0200X Psychologist, Forensic (Licence: MN LP4959) | |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-06-24 |