| NPI | 1174991335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN 1074) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MN 1074) |
| 103T00000X Psychologist (Licence: MN CC01074) | |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2020-12-31 |