NPI | 1154319317 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NJ 35S100258100) |
Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: NJ 35S100258100) |
103G00000X Clinical Neuropsychologist (Licence: NY 005360-1) | |
Enumeration Date | 2005-10-12 |
Last Update Date | 2007-07-08 |