| NPI | 1740053263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP7060) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN PENDING) |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2024-08-28 |