| NPI | 1104180280 |
|---|---|
| Former Name | SHANNON MARIE FOSTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY 9339) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: FL PY 9339) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY 9339) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2022-03-03 |