| NPI | 1407147713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6272) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IA 001186) |
| 103TC1900X Psychologist, Counseling (Licence: IA 001186) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 001186) | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2018-08-06 |