| NPI | 1700941713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP3790) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY 8418) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2018-03-23 |