| NPI | 1639288590 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP1544) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP1544) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2008-06-11 |