| NPI | 1780733774 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4674) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: HI PSY-1910) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2025-03-04 |