| NPI | 1679873525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ND 502) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN LP5545) |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2019-02-26 |