NPI | 1679696272 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: FL PY0003778) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: FL PY0003778) |
Enumeration Date | 2007-04-09 |
Last Update Date | 2007-07-08 |