| NPI | 1215039656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY7306) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: FL PY 7306) |
| 103TC0700X Psychologist Clinical (Licence: FL PY 7306) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2011-10-21 |