| NPI | 1699050179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP5538) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MO 2011004602) |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2012-11-26 |