| NPI | 1750480679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP2754) |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic (Licence: MN LP2754) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP2754) | |
| 103TC1900X Psychologist, Counseling (Licence: MN LP2754) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: MN LP2754) | |
| 103TF0000X Psychologist, Family (Licence: MN LP2754) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2014-03-12 |