| NPI | 1912922832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP3017) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN LP3017) |
| 103TC0700X Psychologist, Clinical (Licence: MN LP3017) | |
| 103TC1900X Psychologist, Counseling (Licence: MN LP3017) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2024-10-21 |