| NPI | 1538754569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP0094) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LPoo94) |
| Enumeration Date | 2021-03-02 |
| Last Update Date | 2021-03-02 |