| NPI | 1265485866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: IA 086405) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MN 5566) |
| 103TC0700X Psychologist, Clinical (Licence: MN 5566) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2021-01-14 |