| NPI | 1508462623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6628) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP6628) |
| Enumeration Date | 2020-12-06 |
| Last Update Date | 2024-06-19 |