| NPI | 1477103794 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 38080) | 
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 38080) | 
| Enumeration Date | 2019-09-18 | 
| Last Update Date | 2021-06-01 |