| NPI | 1205196284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6421) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 05112) |
| Enumeration Date | 2012-05-23 |
| Last Update Date | 2025-10-01 |