| NPI | 1205918547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY0006587) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY0006587) |
| 103TH0100X Psychologist, Health Service (Licence: FL PY0006587) | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2018-05-03 |