| NPI | 1477990570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP 5611) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP 5611) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN LP 5611) | |
| 1744R1102X Specialist, Research Study (Licence: MN LP 5611) | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MN LP 5611) | |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |