| NPI | 1225048242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN MN 4500) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service (Licence: MN MN 4500) |
| 103T00000X Psychologist (Licence: MN MN 4500) | |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2008-11-21 |