| NPI | 1619521465 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IA 114355) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: IA 114355) |
| 103TC0700X Psychologist, Clinical (Licence: KS 2925) | |
| 103TC0700X Psychologist, Clinical (Licence: IA 114355) | |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2022-10-07 |