| NPI | 1205102696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CO PSY.0004734) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO PSY.0004734) | |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2021-09-10 |