| NPI | 1336219120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: ME 1277) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: HI 677) |
| 103TC0700X Psychologist, Clinical (Licence: HI Psy 677) | |
| 103TC0700X Psychologist, Clinical (Licence: ME 1277) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2016-03-01 |