| NPI | 1679524250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: WI 1984) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1984) |
| 103T00000X Psychologist (Licence: MI 005707) | |
| 103G00000X Clinical Neuropsychologist (Licence: ND 450) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: ND 450) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2013-07-15 |