| NPI | 1720515042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY004395) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 103TC0700X Psychologist, Clinical (Licence: MO 2019010428) | |
| Enumeration Date | 2017-05-17 |
| Last Update Date | 2020-12-18 |