| NPI | 1548531957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 35197) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 35197) |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2014-09-23 |