| NPI | 1184200065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6680) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP6680) |
| 103TF0000X Psychologist, Family (Licence: MN LP6680) | |
| 103T00000X Psychologist (Licence: MN LP6680) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP6680) | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2026-03-22 |