| NPI | 1396569000 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP7097) | 
| Additional Taxonomies | 103TF0200X Psychologist, Forensic | 
| Enumeration Date | 2024-11-09 | 
| Last Update Date | 2024-11-09 |