| NPI | 1710393046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP6157) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: RI PS01428) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2022-07-21 |