| NPI | 1568714046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5715) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC0700X Psychologist, Clinical (Licence: WA PY60741487) | |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2024-09-05 |