| NPI | 1790867315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4679) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP4679) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2023-10-27 |