| NPI | 1245534429 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AZ 4275)  | 
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: AZ 3342581)  | 
| Enumeration Date | 2011-01-03 | 
| Last Update Date | 2016-01-06 |