| NPI | 1861796757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 5843) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 3717-125) |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2014-12-02 |