| NPI | 1922301258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6576) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PSY.0004537) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2020-09-03 |