| NPI | 1740513886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MA 9535) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: MA 9535) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2012-12-14 |