| NPI | 1760544423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP2689) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP2689) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2011-05-26 |