| NPI | 1366502072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4912) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MS 46800) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-08-24 |