| NPI | 1609816545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP0876) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP0876) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-11-10 |