| NPI | 1366659716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IA 00569) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IA 00569) |
| 103TC0700X Psychologist, Clinical (Licence: IA 00569) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: IA 00569) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2007-07-08 |