| NPI | 1700179702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CT 002363) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: CT 002363) |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: CT 002363) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2011-05-24 |