| NPI | 1376609495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP0096) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP0096) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MN LP0096) | |
| 103T00000X Psychologist (Licence: MN LP0096) | |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2007-07-09 |