| NPI | 1295053338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6363) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 33361) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2020-09-21 |