| NPI | 1144399353 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IN 20040951A) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: IN 20040951A) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: IN 20040951A) | |
| 103TC1900X Psychologist, Counseling (Licence: IN 20040951A) | |
| 103TF0000X Psychologist, Family (Licence: IN 20040951A) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: IN 20040951A) | |
| 103T00000X Psychologist (Licence: IN 20040951A) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: IN 20040951A) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2007-07-09 |