| NPI | 1952751240 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP6210)  | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: CO PSY0004429)  | 
| Enumeration Date | 2016-06-16 | 
| Last Update Date | 2018-03-17 |