| NPI | 1003965534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 2229) |
| Additional Taxonomies | 103TE1100X Psychologist, Exercise & Sports (Licence: MA 2229) |
| 103TH0100X Psychologist, Health Service (Licence: MA 2229) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: MA 2229) | |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2025-09-11 |