| NPI | 1215307046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5736) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP 5736) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2018-12-13 |