| NPI | 1386837441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4681) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 7979) |
| 103TC0700X Psychologist, Clinical (Licence: MA 7979) | |
| 103TC0700X Psychologist, Clinical (Licence: MN LP4681) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2019-04-05 |