| NPI | 1578175501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 6684) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP6572) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP6572) | |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2024-11-01 |