| NPI | 1124128756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ND 343) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: ND 343) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: ND 343) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: ND 343) | |
| 103TH0100X Psychologist Health Service (Licence: ND 343) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: ND 343) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2023-01-19 |