| NPI | 1710970959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TH0004X Psychologist Health (Licence: AZ 3388) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: AZ 3388) |
| 103TC0700X Psychologist Clinical (Licence: AZ 003388) | |
| 103TR0400X Psychologist Rehabilitation (Licence: AZ 3388) | |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2022-02-08 |