| NPI | 1467609479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN LP-5200) |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports (Licence: MN LP-5200) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2010-11-04 |