| NPI | 1629180013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP5714) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 3544-57) |
| 103TC0700X Psychologist, Clinical (Licence: WV 547) | |
| 103TC0700X Psychologist, Clinical (Licence: MN 5714) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2021-05-03 |