| NPI | 1740800200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TN 3723) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: TN 3723) |
| 103TC0700X Psychologist, Clinical (Licence: NE 602) | |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2022-03-29 |