| NPI | 1649202755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4961) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103TC0700X Psychologist, Clinical (Licence: MN 4961) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2019-06-28 |