| NPI | 1295025997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: AL 1228) |
| Additional Taxonomies | 103T00000X Psychologist |
| 103G00000X Clinical Neuropsychologist (Licence: AL AL-1228) | |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-09-29 |