| NPI | 1093221350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: KY 277928) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: KY 277928) |
| 103T00000X Psychologist (Licence: MI 6301019071) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-12-22 |
| Last Update Date | 2023-09-11 |