| NPI | 1811481476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6925) |
| Additional Taxonomies | 174400000X Specialist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2023-05-23 |