NPI | 1144432774 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MI 6301012812) |
Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MI 6301012812) |
103TC0700X Psychologist, Clinical (Licence: MI 6301012812) | |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MI 6301012812) | |
Enumeration Date | 2007-05-04 |
Last Update Date | 2017-11-28 |