| NPI | 1134203961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: CO 1629) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CO 1629) |
| 103T00000X Psychologist (Licence: CO 1629) | |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2021-02-23 |