NPI | 1114361995 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA 30977) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 30895) |
103TR0400X Psychologist, Rehabilitation (Licence: TX 30895) | |
103TR0400X Psychologist, Rehabilitation (Licence: CA 30977) | |
Enumeration Date | 2013-04-23 |
Last Update Date | 2019-12-05 |