| NPI | 1669401345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP2283) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: MN 0252613-01) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |