| NPI | 1720747082 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6746) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP6748) |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2021-12-15 |