| NPI | 1275575037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP5218) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MI 011396) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 011396) | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-03-17 |