| NPI | 1679070205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TH0100X Psychologist Health Service (Licence: MN LP6585) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP6585) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2021-09-14 |