| NPI | 1477199305 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 1477199305) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 106S00000X Behavior Technician (Licence: TX RBT-19-89367) | |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2024-07-09 |