| NPI | 1699186486 |
|---|---|
| Former Name | GENEVIEVE PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 11729) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2022-03-04 |