| NPI | 1366002602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CA 31034) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN LP6938) |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2024-02-06 |