| NPI | 1396874897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 3296) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MA 3296) |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 3296) | |
| 103TF0200X Psychologist, Forensic (Licence: MA 3296) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MA 3296) | |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2007-07-08 |