| NPI | 1366752503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: PA PS016042) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: PA PS016042) |
| 103TC0700X Psychologist Clinical (Licence: NJ 35S100472500) | |
| 103TR0400X Psychologist Rehabilitation (Licence: PA PS016042) | |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2012-11-12 |