| NPI | 1568585222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: FL PY7495) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY7495) |
| 103TC0700X Psychologist, Clinical (Licence: FL PY7495) | |
| 103TC0700X Psychologist, Clinical (Licence: NY 0133031) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2021-06-11 |