| NPI | 1710977483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MA 2598) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MA 2598) |
| 103G00000X Clinical Neuropsychologist (Licence: OK 998) | |
| 103T00000X Psychologist (Licence: OK 998) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2007-07-08 |