| NPI | 1508988981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP0666) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: MN 311850) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2018-11-30 |