| NPI | 1790012318 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP5726) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: DC PSY1000525) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2017-02-13 |