| NPI | 1790841773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP 5842) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY 23007) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2019-02-10 |