| NPI | 1992583181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MN LP6975) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN LP6975) |
| 103TH0100X Psychologist, Health Service (Licence: MN LP6975) | |
| Enumeration Date | 2023-09-19 |
| Last Update Date | 2023-09-19 |