| NPI | 1407827173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN MN3057) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN LP3057) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2009-08-04 |