NPI | 1104118058 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: LA 327121) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 37321) |
103T00000X Psychologist (Licence: CA PSY 24207) | |
103TC0700X Psychologist, Clinical (Licence: LA 327121) | |
103TC0700X Psychologist, Clinical (Licence: TX 37321) | |
Enumeration Date | 2011-05-11 |
Last Update Date | 2022-09-30 |