| NPI | 1700860137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NC 3189) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: FL PY7652) |
| 103TB0200X Psychologist Cognitive & Behavioral (Licence: FL PY7652) | |
| 103TC0700X Psychologist Clinical (Licence: NC 3189) | |
| 103TC0700X Psychologist Clinical (Licence: FL PY7652) | |
| 103TH0004X Psychologist Health (Licence: FL PY7652) | |
| 103TH0100X Psychologist Health Service (Licence: NC 3189) | |
| 103TR0400X Psychologist Rehabilitation (Licence: NC 3189) | |
| 103TR0400X Psychologist Rehabilitation (Licence: FL PY7652) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2020-07-15 |