| NPI | 1922590710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6583) |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MN LP6583) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2020-09-18 |