| NPI | 1750415782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WI 3029) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP5245) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2018-11-05 |