| NPI | 1700809118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: MO LP0359) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP0359) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP0359) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MN LP0359) | |
| 103T00000X Psychologist (Licence: MN LP0359) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-09 |