| NPI | 1669503843 |
|---|---|
| Former Name | LEANDRA BERRY WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: PA PS017038) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: PA PS017038) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: PA PS017038) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2012-04-30 |