| NPI | 1740463637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4876) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP4876) |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2014-12-04 |