| NPI | 1578055315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6458) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CT 003292) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2019-12-11 |