| NPI | 1215124011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4835) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP4835) |
| 103TF0200X Psychologist, Forensic (Licence: MN LP4835) | |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2019-02-26 |