| NPI | 1184856593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6022) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 23923) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2020-04-29 |