| NPI | 1639248461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP2266) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP2266) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MN LP2266) | |
| 103T00000X Psychologist (Licence: MN LP2266) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-09 |