NPI | 1548392798 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 7339) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 7339) |
103G00000X Clinical Neuropsychologist (Licence: MA 7339) | |
Enumeration Date | 2007-03-12 |
Last Update Date | 2023-11-08 |