| NPI | 1366946949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP7209) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: OH P.07701) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-08-22 |