| NPI | 1417938242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0807X Clinical Nurse Specialist, Psych/Mental Health, Child & Adolescent (Licence: MN R077626-6) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP3166) |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2021-02-10 |