| NPI | 1013392869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: LA 1330) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY9204) |
| 103T00000X Psychologist (Licence: FL PY9204) | |
| 103T00000X Psychologist (Licence: FL 9204) | |
| 103T00000X Psychologist (Licence: LA 1330) | |
| 103TC0700X Psychologist, Clinical (Licence: LA 1330) | |
| 103TC0700X Psychologist, Clinical (Licence: FL PY9204) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: LA 1330) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: FL PY9204) | |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2021-03-30 |