| NPI | 1457335903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: KY 130733) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TN P001673) |
| 103TC0700X Psychologist, Clinical (Licence: TN P001673) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: TN P001673) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: KY 130733) | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2024-01-09 |