| NPI | 1174560932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4039) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP4039) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MN LP4039) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2020-05-19 |