| NPI | 1477264380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist, Health Service (Licence: MN LP7007) |
| Additional Taxonomies | 103TH0100X Psychologist, Health Service |
| 103TH0100X Psychologist, Health Service (Licence: NY 026220) | |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2023-12-20 |