| NPI | 1669527651 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3924) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP3924) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MN LP3924) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN LP3924) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2023-10-30 |