| NPI | 1346623469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 0082) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 10567) |
| 103T00000X Psychologist (Licence: FL 10125) | |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2018-07-29 |