| NPI | 1477200426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ND 626P) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN LP6779) |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2022-04-20 |