| NPI | 1124044375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 5091) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 5091) |
| 103TH0100X Psychologist Health Service (Licence: MA 5091) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2019-07-10 |