| NPI | 1942529557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN 6469) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 7867-123) |
| 1041C0700X Social Worker, Clinical (Licence: WI 127707-121) | |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2019-11-05 |