| NPI | 1013247618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: VA 0810004131) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TF0200X Psychologist Forensic | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities | |
| Enumeration Date | 2010-01-04 |
| Last Update Date | 2010-01-04 |