| NPI | 1770970295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 6090) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN cc00392) |
| 103TH0100X Psychologist, Health Service (Licence: MN 55423) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2022-07-21 |