| NPI | 1477604882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MT 357) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WY 420) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MT 357) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: WY 420) | |
| 103TC0700X Psychologist, Clinical (Licence: MT 357) | |
| 103TC0700X Psychologist, Clinical (Licence: WY 420) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MT 357) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: WY 420) | |
| 103TF0000X Psychologist, Family (Licence: MT 357) | |
| 103TF0000X Psychologist, Family (Licence: WY 420) | |
| 103T00000X Psychologist (Licence: MT 357) | |
| 103T00000X Psychologist (Licence: WY 420) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MT 357) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: WY 420) | |
| Enumeration Date | 2007-01-13 |
| Last Update Date | 2016-12-02 |