| NPI | 1578500781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: OK 1014) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: OK 1014) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: OK 1014) | |
| 103TH0100X Psychologist, Health Service (Licence: OK 1014) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: OK 1014) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: OK 1014) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2011-01-28 |