| NPI | 1235862400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP7078) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN 76553) |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2024-12-02 |