| NPI | 1205845211 |
|---|---|
| Former Name | VICTORIA MARIE CLEVENGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY 6037) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL PY 6037) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2007-07-08 |