NPI | 1235339151 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: KY 129920) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: KY 2012-52) |
103G00000X Clinical Neuropsychologist (Licence: TN 3366) | |
Enumeration Date | 2007-07-19 |
Last Update Date | 2018-04-03 |