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 |