| NPI | 1265215545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP7109) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2024-10-09 |