| NPI | 1457554735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5010) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN 5010) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2023-01-06 |