NPI | 1730662578 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP7159) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OH P.08066) |
Enumeration Date | 2018-09-07 |
Last Update Date | 2025-05-20 |