| NPI | 1194873794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 38477) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP5363) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2021-06-03 |