| NPI | 1700053063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3479) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL 6668) |
| 103G00000X Clinical Neuropsychologist (Licence: NC 3479) | |
| 103T00000X Psychologist (Licence: FL 6668) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: FL 6668) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: NC 3479) | |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2024-10-31 |