NPI | 1316451719 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY004156) |
Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: GA PSY004156) |
Enumeration Date | 2017-11-21 |
Last Update Date | 2019-07-25 |