NPI | 1699750018 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: UT 117391-2501) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: UT 117391-2501) |
Enumeration Date | 2005-12-08 |
Last Update Date | 2013-07-30 |