| NPI | 1548475296 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP3626) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN LP3626) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN LP3626) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2007-07-08 |