| NPI | 1821524836 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SD 628) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MN LP6815) |
| 103T00000X Psychologist (Licence: SD 628) | |
| 103TA0700X Psychologist Adult Development & Aging (Licence: SD 628) | |
| 103TC1900X Psychologist Counseling (Licence: SD 628) | |
| 103TH0100X Psychologist Health Service (Licence: SD 628) | |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: SD 628) | |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-12-25 |