| NPI | 1548669088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP5938) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2020-08-27 |