| NPI | 1154578599 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9584) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9584) |
| 103G00000X Clinical Neuropsychologist (Licence: MA 9584) | |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2015-05-31 |