| NPI | 1184398778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP7013) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: VA 0810008344) | |
| 103TC0700X Psychologist, Clinical (Licence: MD 07225) | |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2024-07-08 |