| 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 |