NPI | 1851085641 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6939) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MN LP6939) |
Enumeration Date | 2023-06-06 |
Last Update Date | 2024-09-16 |