| NPI | 1790199099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN 5757) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: AK 657) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2015-01-26 |