| NPI | 1356369664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 1026) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: SC 1026) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2008-03-05 |