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, Intellectual & Developmental Disabilities (Licence: OR 2484) | |
Enumeration Date | 2014-09-30 |
Last Update Date | 2014-09-30 |