| NPI | 1679874515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 5986) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: KY 1737) |
| Enumeration Date | 2010-11-09 |
| Last Update Date | 2024-01-30 |