NPI | 1649381419 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP2202) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP2202) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2010-06-03 |