| NPI | 1346229325 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6234) | 
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral | 
| 170300000X Genetic Counselor, MS | |
| Enumeration Date | 2006-01-10 | 
| Last Update Date | 2019-08-28 |