| NPI | 1629229455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MI 6301012121) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MI 6301012121) |
| 103TR0400X Psychologist, Rehabilitation (Licence: MI 6301012121) | |
| Enumeration Date | 2008-10-10 |
| Last Update Date | 2019-12-05 |