| NPI | 1336496512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: GA 4100) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA 4100) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: GA 4100) | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2018-03-17 |