| NPI | 1366078081 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 2985) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN 2394) |
| Enumeration Date | 2020-03-13 |
| Last Update Date | 2021-10-19 |