| NPI | 1588270557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6848) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 12306) |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2024-02-09 |