| NPI | 1912357112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 6561) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 0005522) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP6561) | |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2021-04-22 |