| NPI | 1659127611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP7077) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2015017829) |
| 103TC0700X Psychologist, Clinical (Licence: TX 40396) | |
| Enumeration Date | 2024-04-29 |
| Last Update Date | 2026-02-17 |