| NPI | 1407116155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP5885) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY8956) |
| 103G00000X Clinical Neuropsychologist (Licence: MN LP5885) | |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2024-09-05 |