| NPI | 1669515847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 3741) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 3741) |
| 103TH0100X Psychologist, Health Service (Licence: MA 3741) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-07-08 |