| NPI | 1376569236 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TR0400X Psychologist, Rehabilitation (Licence: AL 2123) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: AL 2123) |
| 103TC0700X Psychologist, Clinical (Licence: NC 4461) | |
| 103T00000X Psychologist (Licence: NC 4461) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: NC 4461) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: VA 0810001172) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2019-06-17 |