| NPI | 1699794255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3615) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MN 7027) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2007-07-08 |