| NPI | 1154949873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 11306) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 11306) |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |