| NPI | 1821125964 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4040) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP4040) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2017-03-30 |