| NPI | 1396831962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC1900X Psychologist Counseling |
| Additional Taxonomies | 103TF0000X Psychologist Family |
| 103T00000X Psychologist (Licence: MN LP0403) | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 103T00000X Psychologist | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-08 |