| NPI | 1770612913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3102) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP3102) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2023-07-14 |