| NPI | 1124791140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 38457) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 38457) |
| 103TC0700X Psychologist Clinical (Licence: TX 38457) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: TX 38457) | |
| 103TR0400X Psychologist Rehabilitation (Licence: TX 38457) | |
| 103TS0200X Psychologist School (Licence: TX 38457) | |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2021-07-26 |