| NPI | 1285790279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 8104) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 8104) |
| 103T00000X Psychologist (Licence: MA 8104) | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2011-10-05 |