| NPI | 1104939107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301015369) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301015369) |
| 103G00000X Clinical Neuropsychologist (Licence: OH 6208) | |
| 103G00000X Clinical Neuropsychologist (Licence: KY 1432) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2021-03-28 |