| NPI | 1932191889 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP1772) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN LP1772) |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2007-07-08 |