| NPI | 1134384712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 36210) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CT 002848) |
| Enumeration Date | 2008-07-23 |
| Last Update Date | 2013-02-15 |