| NPI | 1417958893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3518) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP3518) |
| 103TC1900X Psychologist, Counseling (Licence: MN LP3518) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP3518) | |
| 103TF0000X Psychologist, Family (Licence: MN LP3518) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2021-02-10 |