| NPI | 1811106065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP-1767) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP-1767) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MN LP-1767) | |
| 103TP0814X Psychologist Psychoanalysis (Licence: MN LP-1767) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2011-03-05 |