| NPI | 1821192295 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP4404)  | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP4404)  | 
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP4404)  | |
| 103TH0100X Psychologist, Health Service (Licence: MN LP4404)  | |
| Enumeration Date | 2006-09-07 | 
| Last Update Date | 2025-09-11 |