| NPI | 1184063711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 39620) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MA 10430) |
| 103T00000X Psychologist (Licence: VA 0810006990) | |
| 103TC0700X Psychologist, Clinical (Licence: MA 10430) | |
| 103TC0700X Psychologist, Clinical (Licence: TX 39620) | |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2022-11-29 |