| 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 |