| NPI | 1124416276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY9792) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 12975) |
| 103T00000X Psychologist (Licence: FL PY 9792) | |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2019-02-06 |