| NPI | 1649500463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 34687) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TX 34687) |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2014-04-01 |