| NPI | 1609960285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: NC 3170) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: NC 3170) |
| 103T00000X Psychologist (Licence: NC 3170) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2015-07-13 |