| NPI | 1417953951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 103TC1900X Psychologist Counseling (Licence: MN LP3342) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: ND 320) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2007-07-09 |