| NPI | 1598820870 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701004146) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VA 0701004146) |
| 246ZE0500X Specialist/Technologist, Other EEG (Licence: VA 0701004146) | |
| 2472E0500X Technician, Other EEG (Licence: VA 0701004146) | |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2019-01-29 |