| NPI | 1689650657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: IA 001071) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP4338) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2008-09-19 |