| NPI | 1285995373 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9521) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MA 9521) |
| 103G00000X Clinical Neuropsychologist (Licence: CT 3155) | |
| 103TC0700X Psychologist, Clinical (Licence: CT 3155) | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2012-06-05 |