| NPI | 1740956184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 38842) |
| Additional Taxonomies | 103TA0700X Psychologist Adult Development & Aging (Licence: TX 38842) |
| 103G00000X Clinical Neuropsychologist (Licence: TX 38842) | |
| 103TR0400X Psychologist Rehabilitation (Licence: TX 38842) | |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |