| NPI | 1609004472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: TX 36472) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 36472) |
| 103TR0400X Psychologist, Rehabilitation (Licence: TX 36472) | |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2014-06-02 |