| NPI | 1396170965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: WI 3107-57) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: WI 3107-57) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WI 3107-57) | |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2017-12-05 |