| NPI | 1790191252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6503) |
| Additional Taxonomies | 103TS0200X Psychologist, School |
| Enumeration Date | 2014-07-05 |
| Last Update Date | 2020-04-29 |