| NPI | 1780214601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP4792) |
| Additional Taxonomies | 103TF0200X Psychologist Forensic (Licence: MN LP4792) |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2023-10-16 |