NPI | 1245221332 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: FL PY 0005220) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY 0005220) |
103T00000X Psychologist (Licence: FL PY 0005220) | |
Enumeration Date | 2005-10-29 |
Last Update Date | 2020-07-01 |