| NPI | 1144669599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 34510) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 34510) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: TX 34510) | |
| 103TC0700X Psychologist, Clinical (Licence: TX 34510) | |
| 103TH0004X Psychologist, Health (Licence: TX 34510) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: TX 34510) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2020-06-11 |