| NPI | 1104550490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY11524) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY11524) |
| 103TC0700X Psychologist Clinical (Licence: FL PY11524) | |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-07-12 |