| NPI | 1346394947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 7273) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 32043) |
| 103T00000X Psychologist (Licence: MA 7273) | |
| 103T00000X Psychologist (Licence: TX 32043) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2007-07-08 |