| NPI | 1326341447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 5267) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA 24829) |
| Enumeration Date | 2010-12-10 |
| Last Update Date | 2015-08-18 |