| NPI | 1457472540 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP3341)  | 
| Additional Taxonomies | 103TC1900X Psychologist, Counseling | 
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| 103TH0004X Psychologist, Health | |
| Enumeration Date | 2007-04-03 | 
| Last Update Date | 2018-07-27 |