| NPI | 1124313796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NC 4096) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NC 4096) |
| 103TR0400X Psychologist Rehabilitation (Licence: NC 4096) | |
| 103TH0100X Psychologist Health Service (Licence: NC 4096) | |
| Enumeration Date | 2011-06-12 |
| Last Update Date | 2011-12-29 |