| NPI | 1609515089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6795) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP6795) |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2022-10-10 |