| NPI | 1023157666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 2-2616) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: TX 2-2616) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 2-2616) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2007-07-08 |