| NPI | 1205144136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MD 04858) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MD 04858) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 04858) | |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2020-03-16 |