| NPI | 1124262654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY8120) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY 8120) |
| 103T00000X Psychologist | |
| 103T00000X Psychologist (Licence: FL PY8120) | |
| 103TC0700X Psychologist Clinical (Licence: FL 8120) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL PY8120) | |
| 103TF0200X Psychologist Forensic (Licence: FL PY8120) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: FL PY8120) | |
| Enumeration Date | 2009-04-28 |
| Last Update Date | 2021-10-25 |