| NPI | 1588112205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 2388) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: LA 461) |
| 103TC0700X Psychologist Clinical (Licence: LA 461) | |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-12 |