| NPI | 1740574649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS016925) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: DE B10000941) |
| 103T00000X Psychologist (Licence: PA PS016925) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: DE B10000941) | |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2015-11-24 |