| NPI | 1588979934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MA 9686) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MA 9686) |
| 103G00000X Clinical Neuropsychologist (Licence: MA 9686) | |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2013-05-01 |