| NPI | 1962551853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MN LP 1336) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MN LP 1336) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP 1336) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2016-06-22 |