| NPI | 1588614499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP3562) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MN LP3562) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-06-29 |