| NPI | 1649323866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP2843) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP2843) |
| 103T00000X Psychologist (Licence: MN LP2843) | |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2007-07-08 |