| NPI | 1063890614 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 4787) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NC 4787) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 4787) | |
| 103TF0200X Psychologist, Forensic (Licence: NC 4787) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: NC 4787) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: NC 4787) | |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2015-05-15 |