NPI | 1164557948 |
---|---|
Former Name | MARY LINDA LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 35100) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 35100) |
235Z00000X Speech-Language Pathologist, (Licence: TX 11373) | |
Enumeration Date | 2007-02-22 |
Last Update Date | 2020-12-01 |