| NPI | 1740769942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: LA 1462) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: LA 1462) |
| 103TC0700X Psychologist Clinical (Licence: LA 1462) | |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: LA 1462) | |
| 103TH0100X Psychologist Health Service (Licence: LA 1462) | |
| Enumeration Date | 2018-08-08 |
| Last Update Date | 2025-05-19 |