| NPI | 1619103199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: OR 1972) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: OR 1972) |
| 103TC0700X Psychologist, Clinical (Licence: OR 1972) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: OR 1972) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: OR 1972) | |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2022-10-05 |