| NPI | 1285646059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: SD 369) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CO 1148) |
| 103G00000X Clinical Neuropsychologist (Licence: SD 369) | |
| 103G00000X Clinical Neuropsychologist (Licence: CO 1148) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2008-04-01 |