| NPI | 1346644127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP5900) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CT 3405) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2021-03-11 |