| 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 | 2025-05-29 |