| NPI | 1326020553 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 4783) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WI 2302) |
| 103T00000X Psychologist (Licence: WI 2302) | |
| 103TC0700X Psychologist Clinical (Licence: NC 4783) | |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2022-11-11 |