| NPI | 1356471536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP 4921) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NY 013834) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2014-02-17 |