| NPI | 1063890192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301018421) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: DE B10001020) |
| 103TC0700X Psychologist Clinical (Licence: MI 6301018421) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: DE B10001020) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: DE C100) | |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2023-01-20 |