| NPI | 1588014054 |
|---|---|
| Former Name | MARA ROSE CLEMENTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6445) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN cc01251) |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2019-09-16 |