| NPI | 1639694706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6671) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 2870) |
| 103TC0700X Psychologist, Clinical (Licence: KS 2780) | |
| Enumeration Date | 2017-08-09 |
| Last Update Date | 2021-04-09 |