| NPI | 1255878575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 10877) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NY 021618) |
| 103G00000X Clinical Neuropsychologist (Licence: HI PSY-1637) | |
| 103TC0700X Psychologist, Clinical (Licence: NY 021618) | |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2020-01-06 |