| NPI | 1689774168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 630) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 6920) |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2007-07-09 |