| NPI | 1922387950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ND 497) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KS 1400) |
| 103T00000X Psychologist (Licence: MN LP5687) | |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2020-09-30 |