| NPI | 1740763085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6283) |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: MN LP6283) |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2021-07-15 |