| NPI | 1023411485 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: OR 2484) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: OR 2484) |
| 103TC0700X Psychologist Clinical (Licence: OR 2484) | |
| 103TH0004X Psychologist Health (Licence: OR 2484) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: OR 2484) | |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2014-09-30 |