| NPI | 1376614586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP 1840) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MN LP 1840) |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2010-07-19 |