| NPI | 1245327501 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OR 708) | 
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: OR 708) | 
| Enumeration Date | 2006-10-06 | 
| Last Update Date | 2017-03-07 |