| NPI | 1417345364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: AZ 4540) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: AZ 4540) |
| 103TS0200X Psychologist, School (Licence: AZ 4540) | |
| Enumeration Date | 2014-12-30 |
| Last Update Date | 2014-12-30 |