| NPI | 1629073770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: WV 719) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WV 719) |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2013-05-21 |