| NPI | 1093268864 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY12329)  | 
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: OH 7453)  | 
| 103G00000X Clinical Neuropsychologist (Licence: GA PSY004357)  | |
| Enumeration Date | 2016-07-28 | 
| Last Update Date | 2024-10-30 |