| NPI | 1992742043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4613) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NC 2820) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-07-08 |