NPI | 1881607844 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: MN 1154) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN 1154) |
103TP2701X Psychologist, Group Psychotherapy (Licence: MN 1154) | |
Enumeration Date | 2006-08-14 |
Last Update Date | 2007-07-08 |