| NPI | 1255364428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 1100) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CO 2914) |
| 103TC0700X Psychologist, Clinical (Licence: CO 2914) | |
| 103TH0100X Psychologist, Health Service (Licence: CO 2914) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2016-02-01 |