| NPI | 1366521627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 7766) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MA 7766) |
| 103TC0700X Psychologist, Clinical (Licence: MA 7766) | |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2015-09-14 |