| NPI | 1023410115 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 40256) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY9147) |
| 103T00000X Psychologist (Licence: FL 9147) | |
| 103TC0700X Psychologist, Clinical (Licence: TX 40256) | |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2024-10-21 |