| NPI | 1629589833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY9963) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL 9963) |
| 103TH0004X Psychologist, Health (Licence: FL 9963) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: FL PY9963) | |
| Enumeration Date | 2017-10-14 |
| Last Update Date | 2021-03-17 |