| NPI | 1699174326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 38239) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP6011) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2022-10-03 |