| NPI | 1447237821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP0123) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: FL PY8759) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2020-09-02 |