| NPI | 1770832453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5912) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA 21065) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2025-01-23 |