| NPI | 1124667795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA 31653) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL 10146) |
| 103T00000X Psychologist (Licence: FL PY10146) | |
| 103TC0700X Psychologist, Clinical (Licence: FL 10146) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: FL 10146) | |
| Enumeration Date | 2019-12-31 |
| Last Update Date | 2023-12-13 |