| NPI | 1629300959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6833) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN LP6833) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP6833) | |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2023-06-21 |