| NPI | 1033255963 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 2-5561) | 
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 2-5561) | 
| 103T00000X Psychologist (Licence: TX 2-5561) | |
| Enumeration Date | 2007-01-29 | 
| Last Update Date | 2011-05-23 |