| NPI | 1720397300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5798) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 28247) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2019-09-09 |