NPI | 1225017163 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | |
Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP2678) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MN 6046) |
Enumeration Date | 2006-01-10 |
Last Update Date | 2007-07-08 |