| NPI | 1831346873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MN LP 5484) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ND 509) |
| 103TC0700X Psychologist Clinical (Licence: ND 509) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2023-05-08 |