| NPI | 1962570242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MN LP3550) |
| Enumeration Date | 2006-12-02 |
| Last Update Date | 2022-11-10 |