| NPI | 1285686444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP4192) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic (Licence: MN LP 4192) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2007-07-08 |