| NPI | 1225379381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5597) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 3096-57) |
| 103T00000X Psychologist (Licence: MN LP 5597) | |
| 103TC0700X Psychologist, Clinical (Licence: MN LP 5597) | |
| 103TC0700X Psychologist, Clinical (Licence: WI 3096-57) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP-5597) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 3096-57) | |
| Enumeration Date | 2013-03-13 |
| Last Update Date | 2022-08-31 |