NPI | 1386793289 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MT 134) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MT 134) |
103TF0200X Psychologist, Forensic (Licence: MT 134) | |
103TR0400X Psychologist, Rehabilitation (Licence: MT 134) | |
Enumeration Date | 2007-01-09 |
Last Update Date | 2007-07-08 |