| NPI | 1538443452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN 5396) |
| Additional Taxonomies | 103TB0200X Psychologist Cognitive & Behavioral (Licence: MN 5396) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MN 5396) | |
| 103TF0000X Psychologist Family (Licence: MN 5396) | |
| 103TF0200X Psychologist Forensic (Licence: MN 5396) | |
| 103TP2701X Psychologist Group Psychotherapy (Licence: MN 5396) | |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2023-09-07 |