| NPI | 1225123946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP4179) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP4179) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2014-04-10 |