| NPI | 1568015782 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP7012)  | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN cc02164)  | 
| Enumeration Date | 2019-07-17 | 
| Last Update Date | 2024-02-08 |