NPI | 1134345903 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY 0005158) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY 0005158) |
103T00000X Psychologist (Licence: FL PY5158) | |
Enumeration Date | 2007-04-18 |
Last Update Date | 2023-08-18 |