NPI | 1619412285 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: MN LP6088) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP6088) |
Enumeration Date | 2017-01-05 |
Last Update Date | 2017-01-05 |