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 |