NPI | 1740657899 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CO PSY.0005073) |
Additional Taxonomies | 103T00000X Psychologist (Licence: SC 1362) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: CO 5073) | |
Enumeration Date | 2015-08-25 |
Last Update Date | 2021-09-10 |