| NPI | 1548411762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4606) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: MN LP4606) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2021-01-11 |