| NPI | 1396930210 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: MN LP3031) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP3031) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2007-09-13 |