| 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 |