| NPI | 1275677502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NC 3756) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MD 03955) |
| 103TC0700X Psychologist Clinical (Licence: MD 03955) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MD 03955) | |
| 103T00000X Psychologist (Licence: MD 03955) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: MD 03955) | |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2010-11-08 |