| NPI | 1568426286 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS015685) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: PA PS015685) |
| 103T00000X Psychologist (Licence: PA PS015685) | |
| 103TA0700X Psychologist Adult Development & Aging (Licence: PA PS015685) | |
| 103TR0400X Psychologist Rehabilitation (Licence: PA PS015685) | |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2020-09-09 |