| NPI | 1780712265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN LP0237) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP0237) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP0237) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MN LP0237) | |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2007-07-08 |