| NPI | 1568583870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL py6892) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL py6892) |
| 103TC0700X Psychologist, Clinical (Licence: FL py6892) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2012-05-24 |