| NPI | 1821143272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MO 2006029891) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP6497) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2025-12-23 |